Rebbecca Ann Wellborn, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2434-C Issued in AR

Practice address

2305 Old County Rd
Pocahontas, AR 72455-4148

Phone

(870) 892-1005

Fax

(870) 892-0078

NPI assigned

Jul 11, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edgar-Gray Counseling, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jonesboro, AR
  • NPI 1972010106
  Medicare reassignment NPD
• Families, Inc of Arkansas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jonesboro, AR
  • NPI 1770535569
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1134328131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 OLD COUNTY RD",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724554148",
            "telephone_number": "870-892-1005",
            "fax_number": "870-892-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLBORN",
        "first_name": "REBBECCA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2434-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173608795",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5V498",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Warner, DPT
• Cecilia Lynn Watson-Henson
• Emily Christine Weisenbach, COTA/L
• Jordan N Weisenbach, APRN
• Toshia Weisenbach, LPN
• Jessica Wells, PTA
• Alexis Westmoreland, LAC
• Elizabeth Michelle White, LPC
• Kathleen M Whitlock
• William C. Wyatt, O.D., P.a.

• Clinical Social Worker in Pocahontas, AR
• Providers in Pocahontas, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.